Nursing home staff members’ attitudes regarding advance care planning: relationships with different types of knowledge

  • Perla WernerEmail author
  • Ile Kermel Schiffman
Original Article



Advanced care planning (ACP) is an essential component of quality palliative care in nursing homes. Despite the benefits associated with ACP in nursing homes, completion rates are low. Staff members’ knowledge and attitudes toward ACP were found to be main determinants of ACP completion.


To assess nursing home staff members’ attitudes towards ACP and their association to different types of knowledge.


A convenience sample of 138 nursing home staff members (69% female, 53% non-Jewish, 46% nurses) who reported having heard the terms advanced directives and durable power of attorney completed a structured questionnaire assessing attitudes toward ACP, subjective knowledge, and three types of objective knowledge (declarative, legal and procedural) regarding ACP, as well as socio-demographic and professional factors.


Participants expressed positive attitudes toward formal and informal aspect of ACP, although their subjective and objective knowledge in the topic was moderate. Hierarchical regression analyses revealed that the three dimensions of objective knowledge improved significantly the participants’ attitude scores.


There is a need to integrate different types of knowledge in educational programs provided to nursing home staff members to improve their involvement in ACP initiatives with residents and family members.


Advance care planning End-of-life Nursing home Attitudes Knowledge 



This work was supported by the Israel National Institute for Health Policy and Health Services Research (Grant number: 2016/36/a).

Compliance with ethical standards

Conflict of interest

The authors declare that there is no conflict of interest regarding the publication of this paper.

Statement of human and animal rights

The study’s protocol was approved by the Ethics Committee of the Faculty of Social Welfare and Health Sciences at the University of Haifa.

Informed consent

Due to the study anonymous data collection, it was not possible to obtain written consent.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Community Mental HealthUniversity of HaifaHaifaIsrael

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